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Antibiotic use after TNBC diagnosis associated with worse survival outcomes
Key clinical point: Survival outcomes were worsened in women with triple-negative breast cancer (TNBC) who were prescribed monthly antibiotics after TNBC diagnosis.
Major finding: Each additional total and unique monthly antimicrobial prescription was associated with inferior breast cancer-specific survival (hazard ratio [HR] 1.05; 95% CI 1.01-1.08, and HR 1.18; 95% CI 1.13-1.24, respectively) and overall survival (HR 1.05; 95% CI 1.02-1.08, and HR 1.17; 95% CI 1.12-1.23, respectively), with the association sustaining through the third year after TNBC diagnosis.
Study details: This study analyzed the data of 772 women with stage I-III TNBC from the Oncoshare database (including integrated data of electronic medical records and California Cancer Registry) who were treated with or without standard cytotoxic chemotherapy, of which 654 women received antibiotics.
Disclosures: This study was supported by the Breast Cancer Research Foundation, New York, and other sources. The authors declared no conflicts of interest.
Source: Ransohoff JD et al. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun. 2023;14:2053 (Apr 12). Doi: 10.1038/s41467-023-37636-0
Key clinical point: Survival outcomes were worsened in women with triple-negative breast cancer (TNBC) who were prescribed monthly antibiotics after TNBC diagnosis.
Major finding: Each additional total and unique monthly antimicrobial prescription was associated with inferior breast cancer-specific survival (hazard ratio [HR] 1.05; 95% CI 1.01-1.08, and HR 1.18; 95% CI 1.13-1.24, respectively) and overall survival (HR 1.05; 95% CI 1.02-1.08, and HR 1.17; 95% CI 1.12-1.23, respectively), with the association sustaining through the third year after TNBC diagnosis.
Study details: This study analyzed the data of 772 women with stage I-III TNBC from the Oncoshare database (including integrated data of electronic medical records and California Cancer Registry) who were treated with or without standard cytotoxic chemotherapy, of which 654 women received antibiotics.
Disclosures: This study was supported by the Breast Cancer Research Foundation, New York, and other sources. The authors declared no conflicts of interest.
Source: Ransohoff JD et al. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun. 2023;14:2053 (Apr 12). Doi: 10.1038/s41467-023-37636-0
Key clinical point: Survival outcomes were worsened in women with triple-negative breast cancer (TNBC) who were prescribed monthly antibiotics after TNBC diagnosis.
Major finding: Each additional total and unique monthly antimicrobial prescription was associated with inferior breast cancer-specific survival (hazard ratio [HR] 1.05; 95% CI 1.01-1.08, and HR 1.18; 95% CI 1.13-1.24, respectively) and overall survival (HR 1.05; 95% CI 1.02-1.08, and HR 1.17; 95% CI 1.12-1.23, respectively), with the association sustaining through the third year after TNBC diagnosis.
Study details: This study analyzed the data of 772 women with stage I-III TNBC from the Oncoshare database (including integrated data of electronic medical records and California Cancer Registry) who were treated with or without standard cytotoxic chemotherapy, of which 654 women received antibiotics.
Disclosures: This study was supported by the Breast Cancer Research Foundation, New York, and other sources. The authors declared no conflicts of interest.
Source: Ransohoff JD et al. Antimicrobial exposure is associated with decreased survival in triple-negative breast cancer. Nat Commun. 2023;14:2053 (Apr 12). Doi: 10.1038/s41467-023-37636-0
Slower decrease in mammographic breast density observed in women who developed breast cancer
Key clinical point: Women who developed breast cancer (BC) showed a significantly slower rate of decrease in mammographic breast density over time compared with control individuals who did not develop BC.
Major finding: Although breast density decreased over time in all women, the rate of change in breast density was significantly slower in the breast that later developed cancer compared with the cancer-free breast in control individuals (estimate 0.027; P = .04).
Study details: This prospective, nested case-control cohort study followed women with no history of any cancer for 10 years based on screening mammogram or risk factors and subsequently analyzed 289 women who developed BC and 658 matched control individuals.
Disclosures: This study was supported by grants from the Breast Cancer Research Foundation, New York (BCRF) and partly by the US National Cancer Institute (NCI). Two authors declared receiving grants from BCRF and NCI and holding a pending patent for assessment of digital mammograms.
Source: Jiang S et al. Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk. JAMA Oncol. 2023 (Apr 27). Doi: 10.1001/jamaoncol.2023.0434
Key clinical point: Women who developed breast cancer (BC) showed a significantly slower rate of decrease in mammographic breast density over time compared with control individuals who did not develop BC.
Major finding: Although breast density decreased over time in all women, the rate of change in breast density was significantly slower in the breast that later developed cancer compared with the cancer-free breast in control individuals (estimate 0.027; P = .04).
Study details: This prospective, nested case-control cohort study followed women with no history of any cancer for 10 years based on screening mammogram or risk factors and subsequently analyzed 289 women who developed BC and 658 matched control individuals.
Disclosures: This study was supported by grants from the Breast Cancer Research Foundation, New York (BCRF) and partly by the US National Cancer Institute (NCI). Two authors declared receiving grants from BCRF and NCI and holding a pending patent for assessment of digital mammograms.
Source: Jiang S et al. Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk. JAMA Oncol. 2023 (Apr 27). Doi: 10.1001/jamaoncol.2023.0434
Key clinical point: Women who developed breast cancer (BC) showed a significantly slower rate of decrease in mammographic breast density over time compared with control individuals who did not develop BC.
Major finding: Although breast density decreased over time in all women, the rate of change in breast density was significantly slower in the breast that later developed cancer compared with the cancer-free breast in control individuals (estimate 0.027; P = .04).
Study details: This prospective, nested case-control cohort study followed women with no history of any cancer for 10 years based on screening mammogram or risk factors and subsequently analyzed 289 women who developed BC and 658 matched control individuals.
Disclosures: This study was supported by grants from the Breast Cancer Research Foundation, New York (BCRF) and partly by the US National Cancer Institute (NCI). Two authors declared receiving grants from BCRF and NCI and holding a pending patent for assessment of digital mammograms.
Source: Jiang S et al. Longitudinal analysis of change in mammographic density in each breast and its association with breast cancer risk. JAMA Oncol. 2023 (Apr 27). Doi: 10.1001/jamaoncol.2023.0434
Trastuzumab deruxtecan bests standard-of-care in trastuzumab emtansine-resistant HER2+ metastatic BC
Key clinical point: Trastuzumab deruxtecan demonstrated a favorable benefit-risk profile in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) who were refractory or resistant to trastuzumab emtansine and had scarce treatment options.
Major finding: The median progression-free survival was significantly prolonged in the trastuzumab deruxtecan vs physician’s choice treatment group (17.8 vs 6.9 months; hazard ratio 0.36; P < .0001). No new safety signals were reported for trastuzumab deruxtecan.
Study details: Findings are from the phase 3, DESTINY-Breast02 trial including 608 patients with HER2+ metastatic BC who were refractory or resistant to trastuzumab emtansine and were randomly assigned to receive trastuzumab deruxtecan or treatment of physician's choice.
Disclosures: This study was funded by Daiichi Sankyo and AstraZeneca. Five authors declared being current or former employees of Daichi Sankyo, and two authors declared owning stock options in AstraZeneca or Daiichi Sankyo. The other authors reported ties with several sources.
Source: Andre F et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Apr 19). Doi: 10.1016/S0140-6736(23)00725-0
Key clinical point: Trastuzumab deruxtecan demonstrated a favorable benefit-risk profile in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) who were refractory or resistant to trastuzumab emtansine and had scarce treatment options.
Major finding: The median progression-free survival was significantly prolonged in the trastuzumab deruxtecan vs physician’s choice treatment group (17.8 vs 6.9 months; hazard ratio 0.36; P < .0001). No new safety signals were reported for trastuzumab deruxtecan.
Study details: Findings are from the phase 3, DESTINY-Breast02 trial including 608 patients with HER2+ metastatic BC who were refractory or resistant to trastuzumab emtansine and were randomly assigned to receive trastuzumab deruxtecan or treatment of physician's choice.
Disclosures: This study was funded by Daiichi Sankyo and AstraZeneca. Five authors declared being current or former employees of Daichi Sankyo, and two authors declared owning stock options in AstraZeneca or Daiichi Sankyo. The other authors reported ties with several sources.
Source: Andre F et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Apr 19). Doi: 10.1016/S0140-6736(23)00725-0
Key clinical point: Trastuzumab deruxtecan demonstrated a favorable benefit-risk profile in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) who were refractory or resistant to trastuzumab emtansine and had scarce treatment options.
Major finding: The median progression-free survival was significantly prolonged in the trastuzumab deruxtecan vs physician’s choice treatment group (17.8 vs 6.9 months; hazard ratio 0.36; P < .0001). No new safety signals were reported for trastuzumab deruxtecan.
Study details: Findings are from the phase 3, DESTINY-Breast02 trial including 608 patients with HER2+ metastatic BC who were refractory or resistant to trastuzumab emtansine and were randomly assigned to receive trastuzumab deruxtecan or treatment of physician's choice.
Disclosures: This study was funded by Daiichi Sankyo and AstraZeneca. Five authors declared being current or former employees of Daichi Sankyo, and two authors declared owning stock options in AstraZeneca or Daiichi Sankyo. The other authors reported ties with several sources.
Source: Andre F et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Apr 19). Doi: 10.1016/S0140-6736(23)00725-0
Reproductive tract infections associated with lower risk and better prognosis in breast cancer
Key clinical point: Presence of reproductive tract infections had a protective effect against the development of breast cancer (BC) and was associated with a better prognosis in patients with BC.
Major finding: Reproductive tract infections were associated with a lower risk for BC (odds ratio [OR] 0.80; 95% CI 0.65-0.98). Patients with reproductive vs non-reproductive tract infections showed improved overall survival (hazard ratio [HR] 0.61; 95% CI 0.40-0.94), whereas the risk for disease progression was lower in women with reproductive tract infections and >327 vs ≤327 menstrual cycles (HR 0.52; 95% CI 0.34-0.79).
Study details: Findings are from a case-control study including 1003 patients with BC and 1107 cancer-free control individuals and a cohort study including 4264 patients with BC, of which 685 women had a history of reproductive tract infections.
Disclosures: This study was funded by the National Natural Science Foundation of China and Science and Technology Planning Project of Guangdong Province. The authors declared no conflicts of interest.
Source: Li Y et al. Interaction of reproductive tract infections with estrogen exposure on breast cancer risk and prognosis. BMC Womens Health. 2023;23:238 (May 8). Doi: 10.1186/s12905-023-02383-3
Key clinical point: Presence of reproductive tract infections had a protective effect against the development of breast cancer (BC) and was associated with a better prognosis in patients with BC.
Major finding: Reproductive tract infections were associated with a lower risk for BC (odds ratio [OR] 0.80; 95% CI 0.65-0.98). Patients with reproductive vs non-reproductive tract infections showed improved overall survival (hazard ratio [HR] 0.61; 95% CI 0.40-0.94), whereas the risk for disease progression was lower in women with reproductive tract infections and >327 vs ≤327 menstrual cycles (HR 0.52; 95% CI 0.34-0.79).
Study details: Findings are from a case-control study including 1003 patients with BC and 1107 cancer-free control individuals and a cohort study including 4264 patients with BC, of which 685 women had a history of reproductive tract infections.
Disclosures: This study was funded by the National Natural Science Foundation of China and Science and Technology Planning Project of Guangdong Province. The authors declared no conflicts of interest.
Source: Li Y et al. Interaction of reproductive tract infections with estrogen exposure on breast cancer risk and prognosis. BMC Womens Health. 2023;23:238 (May 8). Doi: 10.1186/s12905-023-02383-3
Key clinical point: Presence of reproductive tract infections had a protective effect against the development of breast cancer (BC) and was associated with a better prognosis in patients with BC.
Major finding: Reproductive tract infections were associated with a lower risk for BC (odds ratio [OR] 0.80; 95% CI 0.65-0.98). Patients with reproductive vs non-reproductive tract infections showed improved overall survival (hazard ratio [HR] 0.61; 95% CI 0.40-0.94), whereas the risk for disease progression was lower in women with reproductive tract infections and >327 vs ≤327 menstrual cycles (HR 0.52; 95% CI 0.34-0.79).
Study details: Findings are from a case-control study including 1003 patients with BC and 1107 cancer-free control individuals and a cohort study including 4264 patients with BC, of which 685 women had a history of reproductive tract infections.
Disclosures: This study was funded by the National Natural Science Foundation of China and Science and Technology Planning Project of Guangdong Province. The authors declared no conflicts of interest.
Source: Li Y et al. Interaction of reproductive tract infections with estrogen exposure on breast cancer risk and prognosis. BMC Womens Health. 2023;23:238 (May 8). Doi: 10.1186/s12905-023-02383-3
Breast cancer survivors face increased risk for sexual dysfunction
Key clinical point: Female breast cancer (BC) survivors are at a higher risk of experiencing sexual dysfunction symptoms compared with women from the general population.
Major finding: The risk for sexual dysfunction was higher in female BC survivors compared with women from the general population (hazard ratio [HR] 1.60; 95% CI 1.51-1.70), with the risk being more prominent within the first 5 years after BC diagnosis (HR 2.05; 95% CI 1.89-2.22) and in women who were <50 years old at the time of BC diagnosis (HR 3.05; 95% CI 2.65-3.51).
Study details: Findings are from the Utah Population Database cohort study including 19,709 women age ≥18 years who had survived BC and 93,389 age- and birth state-matched women from the general population.
Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest.
Source: Chang CP et al. Breast cancer survivorship and sexual dysfunction: A population-based cohort study. Breast Cancer Res Treat. 2023 (May 9). Doi: 10.1007/s10549-023-06953-9
Key clinical point: Female breast cancer (BC) survivors are at a higher risk of experiencing sexual dysfunction symptoms compared with women from the general population.
Major finding: The risk for sexual dysfunction was higher in female BC survivors compared with women from the general population (hazard ratio [HR] 1.60; 95% CI 1.51-1.70), with the risk being more prominent within the first 5 years after BC diagnosis (HR 2.05; 95% CI 1.89-2.22) and in women who were <50 years old at the time of BC diagnosis (HR 3.05; 95% CI 2.65-3.51).
Study details: Findings are from the Utah Population Database cohort study including 19,709 women age ≥18 years who had survived BC and 93,389 age- and birth state-matched women from the general population.
Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest.
Source: Chang CP et al. Breast cancer survivorship and sexual dysfunction: A population-based cohort study. Breast Cancer Res Treat. 2023 (May 9). Doi: 10.1007/s10549-023-06953-9
Key clinical point: Female breast cancer (BC) survivors are at a higher risk of experiencing sexual dysfunction symptoms compared with women from the general population.
Major finding: The risk for sexual dysfunction was higher in female BC survivors compared with women from the general population (hazard ratio [HR] 1.60; 95% CI 1.51-1.70), with the risk being more prominent within the first 5 years after BC diagnosis (HR 2.05; 95% CI 1.89-2.22) and in women who were <50 years old at the time of BC diagnosis (HR 3.05; 95% CI 2.65-3.51).
Study details: Findings are from the Utah Population Database cohort study including 19,709 women age ≥18 years who had survived BC and 93,389 age- and birth state-matched women from the general population.
Disclosures: This study was supported by grants from the US National Institutes of Health and other sources. The authors declared no conflicts of interest.
Source: Chang CP et al. Breast cancer survivorship and sexual dysfunction: A population-based cohort study. Breast Cancer Res Treat. 2023 (May 9). Doi: 10.1007/s10549-023-06953-9
Are family members of early-onset BC patients at risk for discordant early-onset cancers?
Key clinical point: Some relatives of women with early-onset breast cancer (BC) may have an increased risk of developing discordant early-onset cancers (other than breast cancers).
Major finding: Among relatives of women with early-onset BC, offspring had a higher risk for any discordant early-onset cancer (standardized incidence ratio [SIR] 1.27; 95% CI 1.03-1.55), siblings' children had an increased risk for early-onset testicular cancer (SIR 1.74; 95% CI 1.07-2.69) and ovarian cancer (SIR 2.69; 95% CI 1.08-5.53), and siblings had an increased risk for early-onset pancreatic cancer (SIR 7.61; 95% CI 1.57-22.23).
Study details: Findings are from an analysis of a population-based cohort including 54,753 relatives from 5562 families of females diagnosed with early-onset BC.
Disclosures: This study was funded by the Cancer Foundation Finland and Academy of Finland. The authors declared no conflicts of interest.
Source: Rantala JNJ et al. Familial aggregation of early-onset cancers in early-onset breast cancer families. Int J Cancer. 2023;153(2):331-340 (Apr 19). Doi: 10.1002/ijc.34538
Key clinical point: Some relatives of women with early-onset breast cancer (BC) may have an increased risk of developing discordant early-onset cancers (other than breast cancers).
Major finding: Among relatives of women with early-onset BC, offspring had a higher risk for any discordant early-onset cancer (standardized incidence ratio [SIR] 1.27; 95% CI 1.03-1.55), siblings' children had an increased risk for early-onset testicular cancer (SIR 1.74; 95% CI 1.07-2.69) and ovarian cancer (SIR 2.69; 95% CI 1.08-5.53), and siblings had an increased risk for early-onset pancreatic cancer (SIR 7.61; 95% CI 1.57-22.23).
Study details: Findings are from an analysis of a population-based cohort including 54,753 relatives from 5562 families of females diagnosed with early-onset BC.
Disclosures: This study was funded by the Cancer Foundation Finland and Academy of Finland. The authors declared no conflicts of interest.
Source: Rantala JNJ et al. Familial aggregation of early-onset cancers in early-onset breast cancer families. Int J Cancer. 2023;153(2):331-340 (Apr 19). Doi: 10.1002/ijc.34538
Key clinical point: Some relatives of women with early-onset breast cancer (BC) may have an increased risk of developing discordant early-onset cancers (other than breast cancers).
Major finding: Among relatives of women with early-onset BC, offspring had a higher risk for any discordant early-onset cancer (standardized incidence ratio [SIR] 1.27; 95% CI 1.03-1.55), siblings' children had an increased risk for early-onset testicular cancer (SIR 1.74; 95% CI 1.07-2.69) and ovarian cancer (SIR 2.69; 95% CI 1.08-5.53), and siblings had an increased risk for early-onset pancreatic cancer (SIR 7.61; 95% CI 1.57-22.23).
Study details: Findings are from an analysis of a population-based cohort including 54,753 relatives from 5562 families of females diagnosed with early-onset BC.
Disclosures: This study was funded by the Cancer Foundation Finland and Academy of Finland. The authors declared no conflicts of interest.
Source: Rantala JNJ et al. Familial aggregation of early-onset cancers in early-onset breast cancer families. Int J Cancer. 2023;153(2):331-340 (Apr 19). Doi: 10.1002/ijc.34538
Anlotinib-chemotherapy combo shows good efficacy and safety in metastatic TNBC
Key clinical point: Anlotinib combined with chemotherapy demonstrated good activity in the treatment of metastatic triple-negative breast cancer (TNBC) along with an acceptable safety profile in a single-arm phase 2 study.
Major finding: The median progression-free survival was 8.8 months (95% CI 6.5-11.1 months), and the median overall survival was 19.0 months (95% CI 12.1-25.9 months). Grade 3-4 treatment-related adverse events (TRAE) included neutropenia (22.5%), leukopenia (20.0%), secondary hypertension (10.0%), hand-foot syndrome (5.0%), vomiting (5.0%), proteinuria (5.0%), and thrombocytopenia (2.5%), and no deaths due to TRAE were reported.
Study details: Findings are from a prospective phase 2 trial including 40 patients with metastatic TNBC who were previously treated with anthracycline or taxane and received anlotinib combined with chemotherapy.
Disclosures: This study received funding support from the Shenzhen Basic Research Program, China, and the National Natural Science Foundation of China. The authors declared no conflicts of interest.
Source: Huang JY et al. A single-arm phase II clinical trial of anlotinib combined with chemotherapy for the treatment of metastatic triple-negative breast cancer. Front Oncol. 2023;13:1122294 (Apr 12). Doi: 10.3389/fonc.2023.1122294
Key clinical point: Anlotinib combined with chemotherapy demonstrated good activity in the treatment of metastatic triple-negative breast cancer (TNBC) along with an acceptable safety profile in a single-arm phase 2 study.
Major finding: The median progression-free survival was 8.8 months (95% CI 6.5-11.1 months), and the median overall survival was 19.0 months (95% CI 12.1-25.9 months). Grade 3-4 treatment-related adverse events (TRAE) included neutropenia (22.5%), leukopenia (20.0%), secondary hypertension (10.0%), hand-foot syndrome (5.0%), vomiting (5.0%), proteinuria (5.0%), and thrombocytopenia (2.5%), and no deaths due to TRAE were reported.
Study details: Findings are from a prospective phase 2 trial including 40 patients with metastatic TNBC who were previously treated with anthracycline or taxane and received anlotinib combined with chemotherapy.
Disclosures: This study received funding support from the Shenzhen Basic Research Program, China, and the National Natural Science Foundation of China. The authors declared no conflicts of interest.
Source: Huang JY et al. A single-arm phase II clinical trial of anlotinib combined with chemotherapy for the treatment of metastatic triple-negative breast cancer. Front Oncol. 2023;13:1122294 (Apr 12). Doi: 10.3389/fonc.2023.1122294
Key clinical point: Anlotinib combined with chemotherapy demonstrated good activity in the treatment of metastatic triple-negative breast cancer (TNBC) along with an acceptable safety profile in a single-arm phase 2 study.
Major finding: The median progression-free survival was 8.8 months (95% CI 6.5-11.1 months), and the median overall survival was 19.0 months (95% CI 12.1-25.9 months). Grade 3-4 treatment-related adverse events (TRAE) included neutropenia (22.5%), leukopenia (20.0%), secondary hypertension (10.0%), hand-foot syndrome (5.0%), vomiting (5.0%), proteinuria (5.0%), and thrombocytopenia (2.5%), and no deaths due to TRAE were reported.
Study details: Findings are from a prospective phase 2 trial including 40 patients with metastatic TNBC who were previously treated with anthracycline or taxane and received anlotinib combined with chemotherapy.
Disclosures: This study received funding support from the Shenzhen Basic Research Program, China, and the National Natural Science Foundation of China. The authors declared no conflicts of interest.
Source: Huang JY et al. A single-arm phase II clinical trial of anlotinib combined with chemotherapy for the treatment of metastatic triple-negative breast cancer. Front Oncol. 2023;13:1122294 (Apr 12). Doi: 10.3389/fonc.2023.1122294
125I seed placement before neoadjuvant chemotherapy good marking method for metastatic lymph nodes in BC
Key clinical point: Targeted axillary dissection (TAD) by marking the metastatic lymph node with 125I seeds before neoadjuvant chemotherapy (NACT) showed excellent identification rates and ruled out the need for remarking before surgery.
Major finding: The identification rates of the marked lymph node (MLN) and sentinel node (SN) were 99.3% and 91.5%, respectively, with the TAD procedure being successful in 91.5% of patients based on the identification of both MLN and SN. Overall, 40.8% of patients achieved axillary pathologic complete response and could be spared from surgery.
Study details: Findings are from a cohort study including 142 patients with BC who underwent TAD after 125I seeds were placed before NACT.
Disclosures: This study was funded by Helsefonden. The authors did not report conflicts of interest.
Source: Munck F et al. Targeted axillary dissection with 125I seed placement before neoadjuvant chemotherapy in a Danish multicenter cohort. Ann Surg Oncol. 2023 (Apr 16). Doi: 10.1245/s10434-023-13432-4
Key clinical point: Targeted axillary dissection (TAD) by marking the metastatic lymph node with 125I seeds before neoadjuvant chemotherapy (NACT) showed excellent identification rates and ruled out the need for remarking before surgery.
Major finding: The identification rates of the marked lymph node (MLN) and sentinel node (SN) were 99.3% and 91.5%, respectively, with the TAD procedure being successful in 91.5% of patients based on the identification of both MLN and SN. Overall, 40.8% of patients achieved axillary pathologic complete response and could be spared from surgery.
Study details: Findings are from a cohort study including 142 patients with BC who underwent TAD after 125I seeds were placed before NACT.
Disclosures: This study was funded by Helsefonden. The authors did not report conflicts of interest.
Source: Munck F et al. Targeted axillary dissection with 125I seed placement before neoadjuvant chemotherapy in a Danish multicenter cohort. Ann Surg Oncol. 2023 (Apr 16). Doi: 10.1245/s10434-023-13432-4
Key clinical point: Targeted axillary dissection (TAD) by marking the metastatic lymph node with 125I seeds before neoadjuvant chemotherapy (NACT) showed excellent identification rates and ruled out the need for remarking before surgery.
Major finding: The identification rates of the marked lymph node (MLN) and sentinel node (SN) were 99.3% and 91.5%, respectively, with the TAD procedure being successful in 91.5% of patients based on the identification of both MLN and SN. Overall, 40.8% of patients achieved axillary pathologic complete response and could be spared from surgery.
Study details: Findings are from a cohort study including 142 patients with BC who underwent TAD after 125I seeds were placed before NACT.
Disclosures: This study was funded by Helsefonden. The authors did not report conflicts of interest.
Source: Munck F et al. Targeted axillary dissection with 125I seed placement before neoadjuvant chemotherapy in a Danish multicenter cohort. Ann Surg Oncol. 2023 (Apr 16). Doi: 10.1245/s10434-023-13432-4
HER2+ early BC: Extent of disease at diagnosis may predict risk for relapse even after pCR
Key clinical point: Pretreatment tumor stage and nodal involvement could predict the risk for disease relapse in patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) who had achieved pathologic complete response (pCR) with neoadjuvant chemotherapy plus anti-HER2 therapy.
Major finding: Patients who did vs did not achieve pCR had prolonged event-free survival (EFS; hazard ratio [HR] 0.39) and overall survival (HR 0.32; both P < .001). However, in patients with pCR, higher pretreatment tumor stage (cT3-4 vs cT1-2; P = .007) and presence of nodal involvement (cN+ vs cN−; P = .039) could worsen EFS.
Study details: This study analyzed the data of 3710 patients with HER2+ early BC from 11 trials who had received neoadjuvant chemotherapy+anti-HER2 therapy, of which 40.4% of patients had achieved pCR.
Disclosures: This study was supported by author Sibylle Loibl. Several authors declared serving as consultants or advisors, receiving honoraria or research funding, or having other ties with various sources.
Source: van Mackelenbergh MT et al on behalf of the CTNeoBC project. Pathologic complete response and individual patient prognosis after neoadjuvant chemotherapy plus anti-human epidermal growth factor receptor 2 therapy of human epidermal growth factor receptor 2-positive early breast cancer. J Clin Oncol. 2023 (Apr 19). Doi: 10.1200/JCO.22.02241
Key clinical point: Pretreatment tumor stage and nodal involvement could predict the risk for disease relapse in patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) who had achieved pathologic complete response (pCR) with neoadjuvant chemotherapy plus anti-HER2 therapy.
Major finding: Patients who did vs did not achieve pCR had prolonged event-free survival (EFS; hazard ratio [HR] 0.39) and overall survival (HR 0.32; both P < .001). However, in patients with pCR, higher pretreatment tumor stage (cT3-4 vs cT1-2; P = .007) and presence of nodal involvement (cN+ vs cN−; P = .039) could worsen EFS.
Study details: This study analyzed the data of 3710 patients with HER2+ early BC from 11 trials who had received neoadjuvant chemotherapy+anti-HER2 therapy, of which 40.4% of patients had achieved pCR.
Disclosures: This study was supported by author Sibylle Loibl. Several authors declared serving as consultants or advisors, receiving honoraria or research funding, or having other ties with various sources.
Source: van Mackelenbergh MT et al on behalf of the CTNeoBC project. Pathologic complete response and individual patient prognosis after neoadjuvant chemotherapy plus anti-human epidermal growth factor receptor 2 therapy of human epidermal growth factor receptor 2-positive early breast cancer. J Clin Oncol. 2023 (Apr 19). Doi: 10.1200/JCO.22.02241
Key clinical point: Pretreatment tumor stage and nodal involvement could predict the risk for disease relapse in patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) who had achieved pathologic complete response (pCR) with neoadjuvant chemotherapy plus anti-HER2 therapy.
Major finding: Patients who did vs did not achieve pCR had prolonged event-free survival (EFS; hazard ratio [HR] 0.39) and overall survival (HR 0.32; both P < .001). However, in patients with pCR, higher pretreatment tumor stage (cT3-4 vs cT1-2; P = .007) and presence of nodal involvement (cN+ vs cN−; P = .039) could worsen EFS.
Study details: This study analyzed the data of 3710 patients with HER2+ early BC from 11 trials who had received neoadjuvant chemotherapy+anti-HER2 therapy, of which 40.4% of patients had achieved pCR.
Disclosures: This study was supported by author Sibylle Loibl. Several authors declared serving as consultants or advisors, receiving honoraria or research funding, or having other ties with various sources.
Source: van Mackelenbergh MT et al on behalf of the CTNeoBC project. Pathologic complete response and individual patient prognosis after neoadjuvant chemotherapy plus anti-human epidermal growth factor receptor 2 therapy of human epidermal growth factor receptor 2-positive early breast cancer. J Clin Oncol. 2023 (Apr 19). Doi: 10.1200/JCO.22.02241
Postmastectomy implants did not increase risk for squamous cell carcinoma in BC patients
Key clinical point: The incidence rate of squamous cell carcinoma (SCC) was extremely low and, hence, of minimal public health concern in patients with non-SCC breast cancer (BC) or carcinoma in situ who underwent implant-based reconstruction.
Major finding: Only 1 woman was diagnosed with SCC after 52 months of BC diagnosis. The incidence rate of SCC after implant-based reconstruction was extremely low (2.37 per million person-years) and was not significantly higher in women with BC than in the general population (standardized incidence ratio 2.33; 95% CI 0.06-13.0).
Study details: Findings are from a cohort study including 56,785 women with BC or carcinoma in situ who underwent cancer-directed mastectomy with implant reconstruction.
Disclosures: This study was supported by the US National Cancer Institute. Some authors declared receiving personal fees or grants or having other ties with several sources.
Source: Kinslow CJ et al. Risk of squamous cell carcinoma of the breast following postmastectomy implant reconstruction in women with breast cancer and carcinoma in situ. JAMA Surg. 2023 (Apr 19). Doi: 10.1001/jamasurg.2023.0262
Key clinical point: The incidence rate of squamous cell carcinoma (SCC) was extremely low and, hence, of minimal public health concern in patients with non-SCC breast cancer (BC) or carcinoma in situ who underwent implant-based reconstruction.
Major finding: Only 1 woman was diagnosed with SCC after 52 months of BC diagnosis. The incidence rate of SCC after implant-based reconstruction was extremely low (2.37 per million person-years) and was not significantly higher in women with BC than in the general population (standardized incidence ratio 2.33; 95% CI 0.06-13.0).
Study details: Findings are from a cohort study including 56,785 women with BC or carcinoma in situ who underwent cancer-directed mastectomy with implant reconstruction.
Disclosures: This study was supported by the US National Cancer Institute. Some authors declared receiving personal fees or grants or having other ties with several sources.
Source: Kinslow CJ et al. Risk of squamous cell carcinoma of the breast following postmastectomy implant reconstruction in women with breast cancer and carcinoma in situ. JAMA Surg. 2023 (Apr 19). Doi: 10.1001/jamasurg.2023.0262
Key clinical point: The incidence rate of squamous cell carcinoma (SCC) was extremely low and, hence, of minimal public health concern in patients with non-SCC breast cancer (BC) or carcinoma in situ who underwent implant-based reconstruction.
Major finding: Only 1 woman was diagnosed with SCC after 52 months of BC diagnosis. The incidence rate of SCC after implant-based reconstruction was extremely low (2.37 per million person-years) and was not significantly higher in women with BC than in the general population (standardized incidence ratio 2.33; 95% CI 0.06-13.0).
Study details: Findings are from a cohort study including 56,785 women with BC or carcinoma in situ who underwent cancer-directed mastectomy with implant reconstruction.
Disclosures: This study was supported by the US National Cancer Institute. Some authors declared receiving personal fees or grants or having other ties with several sources.
Source: Kinslow CJ et al. Risk of squamous cell carcinoma of the breast following postmastectomy implant reconstruction in women with breast cancer and carcinoma in situ. JAMA Surg. 2023 (Apr 19). Doi: 10.1001/jamasurg.2023.0262